Provider Demographics
NPI:1699783936
Name:STETTNER, EDWARD A (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:STETTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5665 NEW NORTHSIDE DR STE 320
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5834
Mailing Address - Country:US
Mailing Address - Phone:770-874-6907
Mailing Address - Fax:770-874-6908
Practice Address - Street 1:677 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1101
Practice Address - Country:US
Practice Address - Phone:404-686-3845
Practice Address - Fax:404-686-4332
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2018-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA53215207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine